On March 30 of this year my husband underwent brachytherapy for prostate cancer. Ever since he has intermittent blockage of the urethra. The Dr. performing the procedure informed him that a seed had been placed too close to the urethra causing irritation, thus the blockage. He has a suprapubic catheter to drain his bladder when the blockage occurs which seems to be getting more frequent - actually can go normally most of the day, but by evening he is blocked again. His doctor suggests leaving the situation the way it is for up to a year before trying to remove scar tissue caused by the seed. Is this good advice or should we seek another opinion.
This is a difficult situation that can only be solved by the treating physician after taking into account the patient's wishes.
The broad guidelines for decision making in my opinion would be as follows:
If the patient had obstructive symptoms from the very beginning- before brachy- this would need to be taken into consideration.
The duration of the SPC and problems with it- eg if the tube is getting blocked due to debris. etc, any febrile UTIs or frank pus like urine (pyuria), bladder stones etc- would need to be taken into consideration.
The patient's choice- does he mind having the SPC tube and using it to relieve obstruction- also needs to be looked at.
Medical intervention could be looked at as a preliminary option- this may or may not be very effective. Finally tranurethral options could also be considered.
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